Objective:To investigate the efficacy and safety of bendamustine combined with anti-CD20 monoclonal antibody in the first-line treatment of older patients with indolent B-cell non-Hodgkin lymphoma (B-iNHL) .Methods:The clinical data of 159 patients with B-iNHL enrolled in 16 hospitals from Jiangsu Cooperative Lymphoma Group from December 1, 2019, to April 20, 2024, were analyzed for regimen efficacy and safety. Bendamustine plus rituximab (BR) and bendamustine plus obinutuzumab (BG) were administered to 139 (87.4% ) and 20 (12.6% ) patients, respectively.Results:Among the 159 patients, 101 (63.5% ) were male and 58 (36.5% ) were female, with a median age of 69 years (range: 60–84). Efficacy could be assessed in 138 (86.8% ) patients. The efficacy assessment demonstrated that the overall response rate was 92.0% with complete and partial remissions in 75 (54.3% ) and 52 (37.7% ) cases, respectively. With a median follow-up of 24 months (range: 4–64), the progression-free survival rate was (87.5 ± 3.0) % and the overall survival rate was (83.2 ± 3.3) %. Of the 27 patients who died, 6 (22.2% ) died due to disease progression. The mean applied dose of bendamustine per cycle was 73.0 (50.8–89.7) mg/m 2 per day, administered on days 1 and 2. Adverse events of grade 3 or higher were reported in 53 (33.3% ) patients, with infection (30 cases,18.9% ) and neutropenia (24 cases, 15.1% ) demonstrating the highest incidence. Conclusion:Bendamustine combined with anti-CD20 monoclonal antibody demonstrated good efficacy and is well-tolerated in the first-line treatment of elderly patients with B-iNHL.

Objective:To investigate the efficacy and safety of bendamustine combined with anti-CD20 monoclonal antibody in the first-line treatment of older patients with indolent B-cell non-Hodgkin lymphoma (B-iNHL) .Methods:The clinical data of 159 patients with B-iNHL enrolled in 16 hospitals from Jiangsu Cooperative Lymphoma Group from December 1, 2019, to April 20, 2024, were analyzed for regimen efficacy and safety. Bendamustine plus rituximab (BR) and bendamustine plus obinutuzumab (BG) were administered to 139 (87.4% ) and 20 (12.6% ) patients, respectively.Results:Among the 159 patients, 101 (63.5% ) were male and 58 (36.5% ) were female, with a median age of 69 years (range: 60–84). Efficacy could be assessed in 138 (86.8% ) patients. The efficacy assessment demonstrated that the overall response rate was 92.0% with complete and partial remissions in 75 (54.3% ) and 52 (37.7% ) cases, respectively. With a median follow-up of 24 months (range: 4–64), the progression-free survival rate was (87.5 ± 3.0) % and the overall survival rate was (83.2 ± 3.3) %. Of the 27 patients who died, 6 (22.2% ) died due to disease progression. The mean applied dose of bendamustine per cycle was 73.0 (50.8–89.7) mg/m 2 per day, administered on days 1 and 2. Adverse events of grade 3 or higher were reported in 53 (33.3% ) patients, with infection (30 cases,18.9% ) and neutropenia (24 cases, 15.1% ) demonstrating the highest incidence. Conclusion:Bendamustine combined with anti-CD20 monoclonal antibody demonstrated good efficacy and is well-tolerated in the first-line treatment of elderly patients with B-iNHL.

【Objective】 To investigate and analyze the serological and molecular biological characteristics of B(A) subgroup in a tertiary hospital in Jiaozhou, Qingdao. 【Methods】 From November 2019 to February 2023, the samples of 12 patients were suspected to be AB subgroup by microcolumn glass bead method and saline test tube method. The exons 6 and 7 of ABO gene were further amplified, sequenced and analyzed to determine the ABO allele type. 【Results】 A total of 9 cases of B(A) subgroup were detected in 26 065 patients in Jiaozhou, with a detection rate of 0.345 ‰ ( 9/26 065 ). Among the 9 cases of B(A) subgroup, 8 cases of serological reaction showed AweakB, and the gene detection was heterozygous for BA.04 gene and O gene.One case of serological reaction showed ABweak, and the gene detection was heterozygous for BA.04 gene and A gene. 【Conclusion】 Blood group serological combined with gene detection can accurately identify ABO blood group. B(A) subgroup alleles can exist in individuals with serological reaction of ABweak.

African swine fever(ASF)is an acute and highly pathogenic hemorrhagic disease of pigs,causing huge economic losses to pig industry.In order to quantitatively detect clinical samples of ASF and inactivated ASFV antigens,the IgG of ASF positive serum was used as capture anti-body and the HRP-labeled p72 monoclonal antibody was used as detecting antibody.The standard curve was drawn with the cell-cultured ASFV,and a sandwich ELISA detection of antigen was es-tablished.The specificity,sensitivity and stability of the method were evaluated.The effects of dif-ferent inactivation methods and adjuvant addition on antigen detection were further evaluated.The results showed that the minimum detection limits of the recombinant protein and the ASFV were 0.1 mg/L and 103.7 TCID50/mL,respectively.There was no cross-reaction with five common porcine pathogenic viruses,and the coefficient variations between batches was less than 10％.The total co-incidence rate with real-time fluorescence quantitative PCR was 92％(23/25).The sensitivity of antigen detection was significantly reduced when antigen was treated by BEI inactivation,and the detection results were severely interfered by aluminum adjuvant and nano-adjuvant.In summary,the sandwich ELISA antigen detection method established is specific,sensitive,and repeatable,with a good consistency to the qPCR method,which provides an effective clinical diagnostic meth-od for ASFV antigen.

Objective:To study the levels of individual dose of radiation workers in a steel enterprise in Baotou City from 2018 to 2022, and analyze the main factors affecting the annual dose, and provide basic data for revising relevant standards.Methods:According to the requirements of occupational external exposure personal monitoring standards (GBZ 128-2019), the personal dose monitoring of workers working in a steel enterprise in Baotou City from 2018 to 2022 was carried out, three months for a period, continuous monitoring 4 periods, and the results were analyzed.Results:A total of 1 360 workers from 10 employers within the enterprise were surveyed. The annual doses were in the range of 0.500 - 0.844 mSv, with an average annual individual dose of 0.676 mSv. Especially, the average annual individulal effective dose to workers for safety management and inspection was 0.986 mSv, hiher than 0.698 mSv to rolling workers, pump operators, and continuous casters ( Z = 56.89, P < 0.001). Additionally, female worders working with the radiation generators had a higher average annual individual effective dose of 0.821 mSv, than 0.691 mSv to the male workers who were exposed to sealed sources possibly in many cases as needed, with a statistically significant difference ( Z =-5.53, P < 0.001). Conclusions:The average annual individual effective dose to radiation workers in an iron and steel enterprise in Baotou City meets the requirements of the relevent national standard. The annual dose of women and some workers is relatively high, so the management of radiation workers should be strengthened and the radiation protection measures in the workplace should be improved.

【Objective】 To explore the laboratory monitoring procedure and its clinical significance in patients with passenger lymphocyte syndrome after liver transplantation. 【Methods】 The Hb and bilirubin levels were monitored in one AB blood type patient post-liver transplantation. The ABO blood group type, unexpected antibody screening test, direct anti-globulin test and acid elution test were performed respectively in blood samples of the patient to identify the serum antibodies and erythrocyte membrane sensitized antibodies. 【Results】 The patent’s Hb level showed a decreasing trend on the day 11 post-operation, reaching the lowest level of 62 g/L on day 17, and his serum bilirubin increased. The patient’s ABO blood type was determined as AB while anti-B antibody was detected in the patient’s serum. The direct anti-globulin test was weakly positive, while the unexpected antibody screening test was negative. Anti-B antibody was detected in the elution and the patient’s serum. The patient′s serum was incompatible with type AB and type B erythrocytes in the cross-matching test, while it was compatible with type A and type O erythrocytes. 【Conclusion】 Through monitoring serum anti-A, anti-B and direct anti-human globulin test, the patients with passenger lymphocyte syndrome after liver transplantation can be early diagnosed and the prognosis can be improved.

Objective To investigate the effect of acupuncture combined with Shenfu injection on brain injury and hemodynamics after cardiopulmonary resuscitation in patients with cardiac arrest.Methods A total of 100 patients who underwent cardiopulmonary resuscitation after cardiac arrest admitted to 903rd Hospital of the Joint Support Force of PLA from May 2019 to May 2022 were selected as the research objects,and they were divided into acupuncture group and combined group,with 50 cases in each group according to the random number table method.The acupuncture group was given acupuncture therapy,and the combined group was injected Shenfu injection on the basis of acupuncture group.S100β,neuron specific enolase(NSE),National Institutes of Health stroke scale(NIHSS)score,mini mental status examination(MMSE)score,hemodynamic index,Glasgow coma scale(GCS)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score and incidence of adverse reactions were compared between two groups.Results After treatment,S100β,NSE,NIHSS score,APACHE Ⅱscore,and heart rate(HR)of two groups were significantly lower than those before treatment,MMSE score,GCS score,cardiac output(CO),central venous pressure(CVP),mean arterial pressure(MAP)were significantly higher than those before treatment(P<0.05).S100β,NSE,NIHSS score,APACHE Ⅱ score and HR in combined group were significantly lower than those in acupuncture group,and MMSE score,GCS score,CO,CVP,and MAP were significantly higher than those in acupuncture group(P<0.05).The incidence of adverse reactions in combined group was significantly lower than that in acupuncture group(χ2=6.453,P=0.011).Conclusion Acupuncture combined with Shenfu injection treatment can improve brain injury and hemodynamics after cardiopulmonary resuscitation in patients with cardiac arrest,and the effect is significant.

Objective:To investigate the clinical, genetic, and clonality related aspects of individuals with Richter transformation (RT) .Methods:From January 2019 to December 2021, 18 RT patients with diagnoses at the First Affiliated Hospital of Nanjing Medical University (Pukou CLL center) were retrospectively examined. The immunoglobin heavy variable (IGHV) gene usage and IGHV-D-J rearrangement pattern of diagnosed CLL/SLL and transformed diffuse large B-cell lymphoma (DLBCL) were compared to determine the clonality relatedness. To investigate the risk factors of RT, Clinical and laboratory data from patients with newly diagnosed CLL/SLL and transformed DLBCL were gathered.Results:The median age of RT was 56.5 (41-75) years old. 17 patients transformed to DLBCL and 1 transformed to Hodgkin lymphoma (HL) . Of 17 individuals who had DLBCL transformation, 15 had CLL/SLL-related clonality and 2 had unrelated clonality. Next-generation sequencing (NGS) analysis of 11 paired initially diagnosed treatment-naive CLL/SLL and RT DLBCL found that EGR2、TP53 and NOTCH1 were among the most frequently mutated genes both in treatment-naive CLL/SLL and in RT DLBCL. In several cases, specific mutations were gained or lost throughout RT, indicating clonal evolution. Among 10 patients before exposure to BTK inhibitors before RT, four patients acquired BTK mutation. The aforementioned mutations should be considered high-risk variables for transformation; in addition, TP53 and EGR2 mutations could be linked to a poor prognosis following RT in patients receiving a cocktail of new medicines.Conclusion:Most RT DLBCL patients in our center are clonality related (15/17, 88.2% ) and we recommend all qualified centers to evaluate clonality relatedness of RT DLBCL patients. There was some variability in the mutational landscape between DLBCL that had undergone a transformation and initially diagnosed, treatment-naive CLL/SLL. The underlying molecular mechanism of RT needs more research.

Objective To apply real-time transperineal ultrasound ( TPUS) to monitor the intra-fractional prostate motion,collect and analyze the data of the prostate motion,aiming to provide evidence for the optimization of the target area and plan of radiotherapy for prostate cancer. Methods TPUS is a non-invasive monitoring technique that utilizes an automatic scanning ultrasound probe to dynamically monitor and correct the motion of organs during radiotherapy. In this study, TPUS was utilized to collect 1588 intra-fractional data of 70 patients with prostate cancer. Prior to each cycle of radiotherapy,CBCT was adopted to correct the errors between intra-factional data by using VMAT. During radiotherapy, real-time ( once per second) ultrasound images were acquired to monitor the 3D motion of the prostate on the x (left+,right-),y (cranial+, caudal-), and z ( abdominal+, dorsal-) axes, emphasizing the analysis of 4D motion of the prostate. Results All patients successfully completed the treatment and data collection. The median time of effective monitoring per faction was 179 seconds (132-286 seconds). During 95% of the monitoring time,the distance of prostate motion was 2. 22 mm in the left direction,2. 17 mm in the right,2. 08 mm in the cranial, 1. 98 mm in the caudal,2. 44 mm in the abdominal and 2. 97 mm in the dorsal direction,respectively. In the x,y and z axes,the percentage of time in which the distance of prostate motion less than 1 mm among the total time was 83. 07%,85. 46% and 78. 27%,respectively,whereas 97. 70%,97. 87% and 96. 45% for＜3 mm, respectively. Conclusions TPUS is a non-invasive real-time monitoring technique,which can detect the 4D motion of the prostate during radiotherapy. By using VMAT,the range of prostate motion is relatively small, and the motion range is less than 3 mm in each direction within 95% of the time.